This medication guide will provide information on bupropion XL (bupropion hydrochloride extended-release) and the brand Wellbutrin XL, Zyban.

What is bupropion (Wellbutrin XL) used for?

• Treatment of depression (major depressive disorder)
• Prevention of seasonal depression (seasonal affective disorder)
• Smoking cessation assistance (only with the brand Zyban)

How does bupropion (Wellbutrin XL) work?

Bupropion is an atypical antidepressant; it works by affecting the levels of different brain chemicals. Bupropion's exact mechanism of action for treating depression is not completely clear. Studies have shown that bupropion inhibits the reuptake of norepinephrine and dopamine, increasing these two brain chemicals' levels in the central nervous system. Bupropion does not affect the levels of serotonin or monoamine oxidase. 

Nicotine causes a release of dopamine. Bupropion is believed to be effective as a smoking cessation agent because it increases dopamine levels in the brain, replacing the dopamine deficiency during nicotine withdrawal. That is how Zyban works to help people quit smoking. 

What is the dosage of bupropion (Wellbutrin XL)?

Typical adult dosing for depression (major depressive disorder):

• Bupropion hydrochloride immediate-release tablets: 

  • Initial dose: take 100 mg by mouth twice daily for 3 days; may increase to 100 mg by mouth three times daily.

  • Maximum daily dose: 450 mg/day

    • The maximum daily dose is 150 mg by mouth three times daily or 100 mg by mouth four times daily.

    • Separate all doses by at least 6 hours

    • Maximum single dose: 150 mg

• Bupropion sustained-release tablets (Wellbutrin SR): 

  • Initial dose: take 150 mg by mouth once daily in the morning for 3 days; may increase to 150 mg by mouth twice daily.

  • Maximum daily dose: 400 mg/day

    • The maximum daily dose is 200 mg by mouth twice daily.

    • Separate all doses by at least 8 hours

    • Maximum single dose: 200 mg

• Bupropion extended-release tablets (Wellbutrin XL):

  • Initial dose: take 150 mg by mouth once daily in the morning for 3 days; may increase to 300 mg by mouth once daily.

  • Maximum daily dose: 450 mg/day

    • The maximum daily dose can be given as 450 mg by mouth once daily.

• Forfivo XL (Bupropion hydrochloride extended-release 450 mg tablet): 

  • Forfivo XL is available as a 450 mg extended-release tablet and should not be used to initiate treatment.

  • For patients who have been using 300 mg/day of another formulation for at least 2 weeks who require a dose of 450 mg/day or patients who are currently using 450 mg/day of another formulation:

    • Take Forfivo XL 450 mg by mouth once daily 

Typical adult dosing for prevention of seasonal depression:

• Bupropion extended-release tablets (Wellbutrin XL):

  • Initial dose: take 150 mg by mouth once daily in the morning for 1 week; if well tolerated, increase to the usual and maximum dose of 300 mg/day

  • Duration of treatment: begin treatment in autumn (before the start of symptoms), continue through winter, and discontinue in early spring.

  • In patients taking 300 mg/day, taper dose to 150 mg/day for 2 weeks before discontinuation.